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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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If he has no push behind his cough then he is beyond the need of PEP. The next steps are torture: feeding tube, or suction machine. The choking on pureed foods means a change in medical status. How much more as a caregiver do you want to do? Will he agree with these treatments to extend life but not helpful to the quality of life. You want ideas from us but you need to speak of these changes to his doctor.
As per the other posters, I agree that this is a medical matter. Stop trying to administer food until a swallow evaluation has been carried out. It may also be unsafe for your husband to take liquids if that's making him choke, as well. If that is the case, wet his mouth with a cloth, sponge, or similar.
This is a very difficult situation for you and your husband. Just do what you can to keep him comfortable. There really isn't much else that you can do.
Sounds like your husband is having swallowing issues from end stage Alzheimer's disease. Has he seen his doctor or Pulmonologist for this, and to let him know the PEP device is no longer effective? Maybe a call to him or her is in order. There may be a medication to loosen the phlegm rather than using the PEP.
You should look into hospice now because if hubby aspirates food into his lungs, it can cause aspiration pneumonia which can be deadly. Hospice can keep him comfortable as he goes thru this difficult time. I'm sorry you're both dealing with this situation.
You need to have a swallow evaluation. This is ordered by the MD and will be done by OT, and can be done in his facility to evaluate his swallow. He should not be fed until this is done. The swallow becomes more and more week. Eventually you will have likely to make the choice between heroic and artificial ways of supplying nutrition such as tube feedings either by PEG implanted into abdomen or by NG tube put down for feeding OR the choice to do Hospice care. Both an NG and a PEG are quite onerous, in danger of getting pulled out with sutures tearing skin or food dumping into the lungs.
At present, however, feeding someone with a poor swallow reflex (symptoms the phlegm you mention and coughing with feeding) is very dangerous. The symptoms you are seeing is indicative of good getting swallowed not into the abdomen but into the lungs. Pneumonia is the eventual result. Pneumonia was once called "The old person's friend" because it helped the aged slip out of this life.
Sorry for the bad news, but this is now a medical issue, and not an issue for advice from a Forum. I would think that the care facility would have been WAY AHEAD of me in telling you all this. It is a very common problem with aging.
I think that the OP is taking care of her husband at home, from her profile. Otherwise, yes, a facility would have brought in medical advice. It's so difficult to know when you're on your own and have never seen this before.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
It may also be unsafe for your husband to take liquids if that's making him choke, as well. If that is the case, wet his mouth with a cloth, sponge, or similar.
This is a very difficult situation for you and your husband. Just do what you can to keep him comfortable. There really isn't much else that you can do.
You should look into hospice now because if hubby aspirates food into his lungs, it can cause aspiration pneumonia which can be deadly. Hospice can keep him comfortable as he goes thru this difficult time. I'm sorry you're both dealing with this situation.
Best of luck to you.
Both an NG and a PEG are quite onerous, in danger of getting pulled out with sutures tearing skin or food dumping into the lungs.
At present, however, feeding someone with a poor swallow reflex (symptoms the phlegm you mention and coughing with feeding) is very dangerous. The symptoms you are seeing is indicative of good getting swallowed not into the abdomen but into the lungs. Pneumonia is the eventual result. Pneumonia was once called "The old person's friend" because it helped the aged slip out of this life.
Sorry for the bad news, but this is now a medical issue, and not an issue for advice from a Forum.
I would think that the care facility would have been WAY AHEAD of me in telling you all this. It is a very common problem with aging.
I think that the OP is taking care of her husband at home, from her profile.
Otherwise, yes, a facility would have brought in medical advice. It's so difficult to know when you're on your own and have never seen this before.